by aileen ahiskali

ILEAP 6

HAITI

Leah Loeffler, PharmD Candidate 2014

“The mental and physical challenges I had to overcome in Haiti were overwhelming at times. The experience was a learning process and has contributed to my personal growth. I loved every minute of this trip through the struggles and achievements we made as a team.”

Sergie Antoine, PharmD Candidate 2014

“Going back to my hometown for the first time after the devastating earthquake of 2010 was an emotional journey. This experience allowed me to give back to my fellow Haitians, be a role model and, hopefully, a source of hope for them!“

Aileen Ahiskali, PharmD Candidate 2014

“Being quickly taken out of my comfort zone, I did not think I’d survive those two weeks. Looking back at it now, I see some of my proudest moments. I conquered many of my fears and overcame the heat and exhaustion. Would I do it again? Absolutely –

without question.”

The Official Newsletter of the

International Learning Experience in

Pharmacy (iLEAP)

Volume 2, Issue 2

The front gate of HC stands out from the rest of the dull, unpaved street. Beautiful

bright colors welcome visitors. At our first glance, we realized that modern

conveniences were in short supply and we’d have to learn to adapt. All of the

toilets, except for one, were compost toilets. Compost toilets are an

environmentally friendly way to effectively manage waste. Showers were outdoors

with cement walls separating each roofless stall. Lindsey, a manager at HC, guided

us around the compound, mentioning the various projects and unique features.

Volunteers from across the world come to HC to learn about and help out with these

innovative projects.

For example, a small home was built from used, cleaned styrofoam that could

withstand greater than 8.0 on the Richter scale. These Styrofoam blocks are

reusable; if an earthquake damaged the house, there would be no need to buy new

blocks. It was an amazing opportunity to see innovative ideas like this, come

together and executed successfully.

Most rooms, including our own, were fabricated from simple or reusable parts. A large dome, constructed from a durable

fabric, housed numerous bunk beds sporting mosquito nets. Another room, in which we stayed, was made from an old

shipping container. Both structures were without doors, instead, sliding curtains took their place. Throughout Haiti, many

families are forced to sleep in ‘shifts’ as there is not enough space for everyone to lay down at the same time. Seeing the

local community housing demonstrated a prime lesson; be thankful for what you have. We were taken completely out of

our element; going from air conditioning and indoor plumbing to humidity and outhouses. Yet, when we were packing to

leave, none of us wanted to say goodbye. Our time in Haiti showed us how blessed we truly are; a lesson learned that

will stay with us forever.

Haiti Communitere (HC) is a

Haitian based organization

that strives for Haitian and

international groups to work

together as a community.

HC was our home for the two

weeks we spent in Haiti.

Haiti Communitere

19 Rue Pelican, Clercine 4

Port-au-Prince, Haiti

Sam Bloch (509) 3753 – 1771 [email protected]

By Aileen Ahiskali

Aileen, Sergie, and Leah

on the front porch of HC.

mailto:[email protected]

Located within HC is an oversized shipping

container, full of medical supplies. All donations

are stored within the container until they are

needed by Ti Kay.

Over the years, donations flowed in from various

sources, and thus created a need for plentiful

storage. Boxes and bags full of medical supplies

and various medications were stored inside. Part

of our mission in Haiti was to re-organize and

clean up the container. The task in front of us was

daunting; we asked ourselves, “Can we actually

do this?!”

We were all nervous to enter the unlit and

cramped container, not knowing what we might

find inside. It turned out there was an

organizational system in place, and there were no

surprises (ie: cockroaches). Countless hours were

dedicated to restoring organization and the final

product was impeccable! We were able to

accomplish a task that all residents at HC deemed

‘impossible’. This will always be marked as one

of our greatest accomplishments.

Walking away from the experience, we stand

proud. Through the undying heat and torturous

humidity, we worked hard for hours on end. With

masks on our faces and gloves on our hands,

nothing could have stopped us from completing

what we set out to do.

BEFORE AFTER

By Aileen Ahiskali The CONTAINER

Sunset view from the top of the container

Sergie, Leah and Aileen inside the container

By Leah Loeffler

Ti Kay, which translates to “little houses” is the name of a non-profit

organization which serves patients infected with tuberculosis (TB)

and/ or human immunodeficiency virus (HIV) in the Hôpital de l'Université d'État d’Haïti (HUEH), a government hospital in Port-au-

Prince. TB, an easily transmissible disease prevalent in Haiti, was

known as the “malady of the little house” because people infected

with TB were quarantined within small houses. An American doctor

Megan Coffee, along with a local TB nurse established Ti Kay after

the earthquake in 2010 because the hospital’s TB and HIV clinic were

no longer functional. Ti Kay houses around 60 patients infected with

TB as well as HIV.

Patients afflicted with TB and/ or HIV are physically weak as the

disease(s) take(s) over their bodies. Daily walks around the complex

are essential for improving patients’ strength physically and

emotionally. All patients are given two meals daily and the very

thin patients known as the “skinnies” are given supplemental meals

like protein drinks about 2-3 times a day. These patients have a

hard time drinking the protein, they may be nauseous or giving up

on life, so someone has to sit with them to make sure that it is

finished. Another snack consisting of a hard-boiled egg and a

banana is selectively given to the thinnest patients because there is

simply not enough to go around. This was hard for our team to get

comfortable doing. Despite limited resources and lack of a proper

facility, we were able to see a young girl named Lovely, transform

from being bedridden to becoming an outpatient! The positive

outcomes of Ti Kay make the hardships worth it and sick patients

seem less hopeless.

The medications administered through Ti Kay are

limited based on availability and administered by

the nurses. Ti Kay’s pharmacy consists of desk

space, shelves and file cabinets in an office and a

storage tent with medications and supplies. As

pharmacy students, it seemed as though there

wasn’t very much pharmacy to practice. However

we learned that we would be able to contribute by

transforming the clinic’s storage tent of medications

and supplies into a functional use of space.

Ti Kay, like many non-profit organizations relies on

volunteers and donations to bring in medical

supplies. Because of limited staff and fluid job

descriptions, it is difficult to maintain organization

of the tent. The first day we were handed the keys

to the ominous tent, we were all taken aback as we

unzipped the opening. Boxes were piled high as

well as blocked the entrance, making entering

impossible.

BEFORE

AFTER

TI KAY

Our first plan consisted of categorizing each drug

by name, strength, and formulation such as tablet,

suspension, IV solution, etc. This is when we

encountered our first major obstacle and realized

we were no longer in America!

We came to Haiti with packing tape, tons of zip-

lock bags, and markers, but there were just so

many drugs that we ran out of bags in half a days

work. Zip-lock bags and plastic storage bins are a

very expensive commodity in Haiti.

So we had to reconfigure our plan. We then

decided to categorize drugs by class, for example

antibiotics, antifungals, first-aid and so forth. This

increased our productivity and available resources.

We were so efficient we completed our project in

less than one week, ahead of schedule.

We were amazed at the outcome, because you

can now walk inside the tent and see which

medications are on the shelves and every box is

labeled appropriately. We made a diagram that

maps out the categorized medications, so that the

tent is functional for anyone to use.

On our third day organizing the tent we met two patients

with TB/HIV who would help us complete our task as well as

become our friends. “Michnida” is a 12 year-old girl; her date of

birth is unknown because she is an orphan. She resides at the

hospital and was our resident large insect killer. Christopher,

also known as Dragon, is a 19 year-old boy who managed

heavy box movement. They killed dozens of roaches, as we

screamed running out of the tent, and helped with the manual

labor such as cleaning and removing debris. The morale of the

whole experience was lifted by their presence and never-

ending smiles.

During breaks away from the tent we would teach Michnida

and Chris English in return for Creole. As a token of our

appreciation we gave Michnida a sundress and a soccer ball for

Chris!

From this experience, we have observed that Ti Kay is an

amazing program which provides much needed services to a

community which may not receive them otherwise. We feel

very privileged to have been given this opportunity to

contribute to this program.

“Great things came from organizing the tent.”

Sorting donations at HC

We had a feeling that someone was watching us while we were organizing the tent… Turns

out, we were right!

Cleaning & organizing with the help of outpatient, Chris Dragon.

These patients shared their incredible stories with us. Their spirited

determination to live is what ultimately led to their recovery from TB.

Sorting through chemotherapy donations

Suitcases full of

donations

View from the front seat

Vivid images and bright colors covered the vast majority of tap-taps (our major form of transportation while in Haiti)

The primary method of garbage disposal in Haiti:

burning it in

the streets

Our last day at the clinic

An external view of the tent at the clinic

There is only one pharmacy program in Haiti, offered

in the medical school of the national university,

Université d’Etat d’Haïti, Faculté de Médecine et de Pharmacie. We were fortunate to be able to meet

with the current Vice Dean of the pharmacy program

Mrs. Magalie Rosemond. In just one year, her

ambition has led to improvements, paving the way

for future endeavors. She was in charge of the

Direction Centrale de Pharmacie et de Contrôle des Substances Chimiques (DCP/CSC), the Central

Department of Pharmacy and Regulations of Chemical

Substances of the Department of Health and of the

Population in Haiti before assuming the role of Vice

Dean in July 2012.

The pharmacy program accepts 50 students annually

based on an entrance exam administered every

August. Similar to our pharmacy program, third and

fourth year students have introductory and advanced

pharmacy practice experiences in community

pharmacies, industries, and the Hôpital de l'Université d'État d’Haïti, a government hospital. The

fifth and final year of service may be spent in a

hospital, community pharmacy, or warehouse.

Students graduate with a Bachelor’s degree in

pharmacy.

Part of the vision for the pharmacy program is to

provide students in good academic standing the

opportunity to pursue clinical and industrial careers.

After students have completed the final year of

service, they may take a specialized exam to be

eligible for post-graduate training, similar to an

American residency.

The Vice Dean is very interested in developing an exchange

program where students from both countries can experience

healthcare in different settings. The target for this initiative is

to increase the quantity of trained personnel in the country and

improve the quality of care provided to the local community.

We give Vice Dean Rosamond all of our support with her

ambitious projects for the progress of the profession of

pharmacy in Haiti! We hope that the iLEAP program will be able

to develop a strong relationship that will ultimately improve

patient care in Haiti.

By Sergelyne Antoine

Université d’Etat d’Haïti, Faculté de Médecine et de Pharmacie

89, rue Oswald DURAND

Port-au-Prince, HT6110

http://fmp.ueh.edu.ht/

Pharmacy Education

The chemotherapy center is across the street from the hospital.

Dr. Vincent DeGennaro ensures that the facility runs smoothly and

that the nurses are continuously trained to administer the

medications. We were able to bring a much needed

chemotherapy drug donation with us from the U.S. He told us that

it is extremely challenging to find the most consistent, affordable,

sustainable supply. The facility provides patients with a

comfortable place to receive their therapy every day of the week.

The building has several classrooms where health care providers

can meet and receive training. While they have the essentials to

run the facility, the center is still under construction. Because of

the lack of resources, the staff must think creatively to provide

patient care. An example of this is their hood made from an old

neonate incubator to compound chemotherapy intravenous bags.

This proves how committed they are to provide the best care

possible by making what they have work!

Project Medishare By Sergelyne Antoine

In contrast to the Hôpital de l’Université d’Etat d’Haïti, a

government hospital, we also visited a private hospital Hôpital

Bernard Mevs which partners with Project Medishare, a non-

profit organization established in Haiti 12 hours after the

earthquake.

The facility in Haiti offers critical and trauma care, as well as

newborn and pediatric intensive care. It includes a cholera

treatment facility, an advanced prosthetic facility, several rural

community centers, and most recently, a chemotherapy center.

Martin Elie Pharm.D. is in charge of the hospital’s

main pharmacy. He is a Haitian pharmacist who

graduated from St. John’s University School of

Pharmacy. His accomplishments are really inspiring

for us future pharmacists. After the earthquake, he

rebuilt the pharmacy from nothing. He started from

designing to building to programming the computer

system and structuring the workflow without any

prior experience. He has trained his technicians how

to dispense most inpatient medications and

intravenous solutions. As he told us, it is still a work

in progress as he is always looking for new ways to

improve workflow and patient care. He is currently

working on a big project for medical waste disposal

at the hospital which would ultimately be applicable

to the entire country.

Our visit to the Hopital Bernard Mevs allowed us to

observe a different side of healthcare in Haiti.

Project Medishare has a well-structured volunteer

program and lodging facilities for their volunteers.

We urge anyone to consider this experience; it will

allow you to learn as we did and/or to make a

difference in patients’ lives!

Hôpital Bernard Mevs (Project Medishare)

Blvd Toussaint Louverture Village Solidarite # 2

Britney Crush (509) 3471-0870

www.projectmedishare.org

From right to left: Martin, Suzanna, Sergie, Aileen, Leah, Vince

During our trip, we had the opportunity to visit one of three drug

companies in Haiti. Les Laboratoires 4C, the 4C Laboratories,

was founded in 1952 by a Haitian-Canadian association. In 1978,

it was taken over by a group of Haitians who had the goal of

becoming one of the biggest pharmaceutical companies in the

country. Their motto is “Notre priorite c’est votre santé” which

means “Your health is our priority”. The 4C stands for Carribean

Canadian Chemical Company. They manufacture around 145

products and import about 65 products from different countries.

Their products range from medications to baby formula, protein

powder, and other essential products.

Laboratoires 4C

Rte de Delmas and Delmas 71 T(509) 2249-4000 F(509) 2249-0379

www.laboratoires4C.com

4C Laboratory

On our last day, we visited Future for the Kids, an

orphanage cofounded by Mr. Frantz Lafalle and Ms. Sene

Carlune. The first location of FKO was destroyed by the

massive earthquake in 2010; luckily no one was injured but

the damage was devastating. The new location lacks

sufficient resources; however it does provide a safe haven for

the children. We brought an assortment of toys and

educational aids to distribute. We learned that to hire a cook,

launderer and teacher would cost less than $100 per month to

sustain the entire orphanage. The children left a lasting

impression on all of us; regardless of their unfortunate

circumstances, they remained full of life and excitement.

Future for the Kids

[email protected] http://futureforthekids.blogspot.com/

By Aileen Ahiskali

http://futureforthekids.blogspot.com/

My name is Katrina and I attended the medical mission to Haiti

in 2012 with Dr. Gim and Dr. Cha. Since then I graduated and

worked for Walgreens as a floater in NYC for 4 months before

accepting a position at Troop Medical Clinic, which is a mixed

acute/ambulatory-care setting, stationed at Camp Atterbury

Military base in Indiana. I have been providing pharmacy

services to our uniformed members who are mobilizing and

demobilizing as well as civilian contractors completing missions

overseas. Shortly after starting this position, I began working

on a pharmacy practice implementation project with Major

Rego, the active-duty pharmacist at the clinic. We've collected

data to determine the prevalence of polypharmacy in service

members deployed overseas in order to assess the need and

determine the feasibility of having a clinical consult service

consisting of comprehensive medication therapy reviews. When

I am not practicing pharmacy, I am holding jewelry making

classes at a Parks and Recreation Facility in my town, taking

road trips over the weekends, and making sushi at home

because, unlike in NYC, it cannot be found for many miles from

quiet small town of Franklin.

A

L

U

M

N

I

Thank You

Adam & Shelby Moser Adam Loeffler Adrianne LePore Aionga Alexandra Broadus Alexandra Jelcic Anastasia Rivkin Angelo Maropakis Angie Davanos Anna Kang Anne Kugler Anne Ryan Dello Russo Barbara Finizio Bazlah Chaudhry Biana Mindorf Boyoung Kim Bryan & Jana Guaerini Buy-Rite Pharmacy Claudia Rossel Danielle Lai Dave & Jamie Garfinkle Declasse Denise Liu Dr. Berkowitz Dueanereade Costumers Ekta Sighal Elizabeth Watson Eric & Tanya Oddo Eugene Glukhovskiy Fendia & Elisabeth Gina Baranello Gregory Stein Harold&Doreen Partelow Isin & Gulsi Erel James Jane Keyserman Jean Serge & Jaqueline Antoine Jeffrey Quinto Jeri Loeffler Jerry Bianco Jim Davidson Joanna Fattrosso Joe Bianco Joey Fonacier John Gannon John & Jill Ostipwko Justin Kang

Karen Congro Karina Muzykovsky Karl & Cheryl Erickson Kathleen Minlionica Karina Muzykovsky Karl & Cheryl Erickson Kathleen Minlionica Karl Loeffler Kevin Lee Larry & Cynthia Hatfield Leah Peckerman Leila Tibi-Scherl Liberty Quinto Lillian Venezies Linda Ludwig Lindsay Goldstein Lisa Kim Manish Sharma Margie Mary Gannon Mary Gillman Michael Bender Michale Kanfm Mary Kimball Mikhail Inglin Morristown Library PATH Patricia Saunders Paul Finizio Paurul Sighal PharmD class '13,'14 Regine Beliard Rodney St Fleur Ruth Bensley Serhat & Kay Ahiskali Sophia Del Tammy Vo Tien Truong Timothy Nguyen Travis & Jessica Georgieff Victor Emmanuel Joseph Wei William Vincent Xiushan Lai Lewis Ziya Bucukoglu

A special thanks goes out to our professor, Dr. Suzanna Gim.

Without her, this experience would not have been possible.

We all wish her the best of luck with future iLEAP teams,

and hope to work together again one day.

by aileen ahiskali

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